Distortion of body image perception in the Prader-Willi syndrome: Relationship with the perceptual reasoning index

Introduction

Self-perception of body image has been scarcely evaluated in people with Prader-Willi syndrome (PWS), who, in addition to intellectual disability, are often obese. Therefore, we explored whether people with PWS can accurately identify their true image and how this self-perception is impacted by their neuropsychological profile.

Methodology

This observational study included patients with PWS with regular attendance to transdisciplinary treatment at a center specialized in the management of rare diseases. All patients were evaluated with the Stunkard scale (including silhouettes ranging from extremely skinny to extremely obese) and the WISC-IV and WAIS-III questionnaires, specifically the perceptual reasoning index (PRI).

Results

Among the 21 participants, 62% misperceived their body image, most underestimating their body dimensions (actual BMI 28.0 ± 8.3 kg/m² vs self-perceived BMI 23.2 ± 4.7 kg/m², p = 0.03). While BMI differences between accurate and inaccurate body image perception were nonsignificant (accurate 26.6 ± 8.8 kg/m² vs inaccurate 28.9 ± 8.1 kg/m², p = 0.56), individuals with accurate perception showed both higher PRI scores (accurate 67.6 ± 8.2 vs inaccurate 60.2 ± 7.2, p = 0.043) and, to a lesser extent, intelligence quotients (IQ) (accurate 60.0 ± 4.9 vs inaccurate 55.0 ± 7.5, p = 0.079).

Conclusion

In this study, we identified distortion of body image perception as a very common finding among PWS patients, in most cases as underestimation, and influenced by the neuropsychological profile.